This medical condition is commonly known as piles. Ancient references to symptomatic haemorrhoidal disease date back thousands of years and can be found in the Bible as well as early Egyptian, Babylonian, and Greek scripts. The first known mention of this condition is from an Egyptian papyrus in 1700 BC.
Hemorrhoids is basically dilated veins within the anal canal. It is one of the most common gastrointestinal disorders seen.
Hemorrhoids are mentioned in ancient medical writings of every culture. The word "haemorrhoids" is derived from the Greek "haema means blood, and "rhoos" means flowing, and was originally used by Hippocrates to describe the flow of blood from the veins of the anus. Commonly in society it is known as piles, the rod pile is derived from Latin, meaning a ball of a mass, as this condition may not always be accompanied by bleeding. The French call them figs, means to clot.
- Medical Condition: Hemorrhoids
- Definition: Enlargement of veins in the walls of anus and around the rectum
- Other name / Synonyms: Piles
- Main Cause: Chronic constipation and symptom of some other clinical condition
- Affected organs: Anus, rectum and blood vessels
- Prevalence: More than half of men and women aged 50 years and older will develop haemorrhoid symptoms during lifetime.
- Symptoms: Itching, bleeding, discomfort, pain, swelling in anal region
Types of Haemorrhoids
Hemorrhoids can be broadly divided into two categories, based on location viz. internal and external.
Internal haemorrhoid means it is within the anal canal and internal opening of anus. It is often covered with mucous membrane and it is bright red or purple in colour.
External haemorrhoid is situated outside the anal opening and is covered by skin. Sometimes both the conditions coexist and the condition is called interno-external hemorrhoids.
Cause of internal haemorrhoids
There are many reasons which contribute to development of piles in an individual. Some of them are described below:
Hereditary: It is often seen within family members.
Chronic Constipation: One of the major causes of hemorrhoids is straining to expel constipated stool. Some of other medical condition is diarrhea, dysentery, enteritis increases haemorrhoids.
Low dietary fiber intake: Low roughage may excite haemorrhoid formation. Adding bulk or roughage in diet can prevent haemorrhoid formation.
Hemorrhoids can be secondary to a few conditions, and this is known as secondary hemorrhoids. Some conditions which increases the risk of Hemorrhoids are:
- Carcinoma of the rectum
- Pregnancy causes pressure in anal region and it may induce hemorrhoids.
- Chronic constipation that causes extra pressure.
- Difficulty in urination (conditions like enlarged prostate will cause increase intra-abdominal pressure and will raise the venous pressure in the veins to cause hemorrhoids)
In some cases this condition can also be due to body habits, customs, passions, tight-laced clothes, climate and seasons.
Conditions like spinal-cord injuries, constipation, chronic diarrhea, poor bathroom habits, postponing bowel movements can be contributing factors. Alcoholic cirrhosis can also cause severe hemorrhoids.
Symptoms / Clinical features
There are many symptoms of piles and the most common is discomfort in anal region. Other symptoms include bleeding, itching, mucus discharge and pain while motion.
Bleeding which is bright red, painless and occurs along with passing stools.
The patient complains that it splashes in the pan as the stool comes out. This may continue for months or even years. As the conditions advances partial prolapse will occur with each effort of passing stool.
Excessive straining, rubbing, or cleaning around the anus may make symptoms, such as itching and irritation
- Pain is not characteristic of haemorrhoid unless there is associated thrombosis or there’s is associated fissure.
- Mucous discharge is a particular symptom of prolapsed haemorrhoids. This softens and excoriates the skin at the anus.
- Anaemia is often seen in long standing case of haemorrhoids due to persistent and profuse bleeding.
- Prolapse: is a later symptom. In beginning prolapse is minimal.
Prolapse can be divided into 3 degrees-
- First degree: haemorrhoid does not come out of the anus. The mucosa barely prolapse, but with severe straining may be trapped by the closing of the anal sphincter.
- Second degree: haemorrhoids come out only during stool and is reduced spontaneously after stool. With further protrusion of the mucosa, the patient complains of an obvious lump, but this disappears spontaneously and rapidly after passing stool.
- Third degrees: haemorrhoids come out only during stool and not return by themselves, but need to be replaced manually and then they must be reduced. Persistent prolapsing produces dilatation of the anal sphincter, and the haemorrhoids protrude with minimal provocation and usually require manual replacement.
- Fourth degree: The haemorrhoids that are permanently prolapse. At this stage great discomfort is complained of with a feeling of heaviness in the rectum.
Complications of haemorrhoids
Bleeding: A patient with firs degree and early stage of the second degree is seen with bleeding. In fourth degree bleeding is not that profuse. A patient, with first degree haemorrhoid for quite a long time will become anaemic. Bleeding usually occurs externally.
- Thromboisis-Patient notices an acute swelling which is painful.
- Second degree haemorrhoids are more often affected by strangulation.
- Gangrene occurs when the arterial supply of the haemorrhoid is constricted. Massive ganggrene may initiate spreading anaerobic infection.
- Fibrosis occurs in some conditions.
- Pus can also occur in some condition.
Diagnosis of haemorrhoids
Proctoscopic examination, is always suggested and in some sigmoidoscopy or colonocscopy is also suggested. It will reveal the internal pile. Anoscopy is the most accurate method for examining the anal canal and the distal rectum.
Remedies associated with haemorrhoids
In Homeopathy, many remedies are available which are given according to symptoms seen in particular individual.
Patient has tendency to pain in stomach along flatulence. There is alternation of haemorrhoidal suffering with cerebral and cardiac troubles. Haemorrhoids are seen during pregnancy and during child birth, with constipation and mal position of uterus.
There is chronic, painful bleeding piles, with sensation of sticks in rectum, dry balls of light-colored faeces. Patient has so much straining so that prolapse of rectum occur with forcing -down pains even when urination. Tendency of dry faeces. There is aching in the anus. Constipation during pregnancy. Alteration constipation and diarrhoea and great flatulence. Itching in anus is also seen.
- Symptoms Worse by: at night, from slightest mental emotion or excitement, cold
- Symptoms Better by: morning, heat.
- Dosage: Collinsonia 30, 4 pills 3 times in a day for 1 week.
2. Carbo veg
Patient has discharge of a corrosive substance from anus, causing much itching and some burning is also felt. There is much soreness and much itching. Patient has protruding large bluish piles with offensive smell, and burning pains. Patient has constipation with burning stools and discharge of blood. This condition is seen in people who drinks alcohol. Flatus hot, most and offensive. There is itching, and burning in the rectum. There is soreness, itching in anus. Painful diarrhoea in old people. There is frequent, involuntary stools followed by burning. There is bluish burning piles with pain after stool.
- Symptoms Worse by: evening, night and open air, cold from fat food, butter, coffee, mild, warm damp weather, wine.
- Symptoms Better by: from eructation, from fanning, cold.
- Dosage: Carbo veg 30, 4 pills 2 times in a day for 1 week.
3. Causticum: Haemorrhoids accompanies with obstinate constipation, with ineffectual urging and related to fistula. There is itching, stinging, burning, painful when touched. Pain increased when walking, standing, when thinking of them, frequent sudden, pressing pain, penetrating pain in rectum. The stool passes better standing, pain worse from mental exertion. Stool soft and small, hard tough, covered with mucus, shines like grease, small shaped, expelled after much straining, or only on standing, Rectum sore and burns. Patient seen with fistula and large piles.
- Symptoms Worse by: dry cold winds, cold air, from motion of vehicles.
- Symptoms Better by: in damp, wet weather, warmth, hat of bed.
- Dosage: 200 1 time a day for 1 week.
3. Bryonia: Hard, tough stool with protrusion of rectum, long-lasting burning in rectum after hard stool. Or sharp burning pain in rectum with soft stool, white and turbid urine, sensation of constriction in urethra when urinating. Sensation of plug in anus. Constipation stools hard, dry, as if burnt, seem too large. Stools brown, thick, bloody, worse in the morning, from moving, in hot weather, after being heated, from cold drinks, every hot weather.
- Symptoms Worse by: Mornings, from motion and from heat, warmth, any motion, morning, eating, hot weather, exertion, touch.
- Symptoms Better by: While lying down or getting warm in bed, pressure, rest, cold things.
- Dosage: Bryonia 200, 3 times a day for 3 days.
4. Antimonium crud
Copious haemorrhoidal haemorrhage accompanying a stool of solid faecal matter, there is pricking burning, continuous mucous discharge, staining yellow. There is feeling of soreness in rectum, as if an ulcer had been torn open, and alternate diarrhoea and constipation, increased and frequent discharge of urine at night with discharge of mucus, burning in urethra and pain in back. There anal itching. Diarrhoea alternates with constipation, especially in old people. Diarrhoea after acids, sour wine, baths, overeating, slimy, flatulent stools, there is hard lumps mixed with watery discharge. Stools composed entirely of mucus.
- Symptoms Worse by: In evening, from heat, acids, wine water, and washing.
- Symptoms Better by: -in the open air, during rest, warmth.
- Dosage: Antimonium crud 200, 3 times a day for 3 days.
5. Apis mel
There is small protruding haemorrhoids, which sting, burning and smart in tolerably, there is prolapsus ani with haemorrhage from the bowels, burning pain in anus. Constipation, feeling in rectum as if it were stuffed full, with heat and throbbing, scanty urine due to haemorrhoids. Involuntary stools on every motion. There is bloody, painless. Anus feels raw. Haemorrhoids, with stinging pain. Diarrhoea watery , yellow. Cannot urination without passing stool. Dark, fetid, worse after eating.
- Symptoms Worse by: heat, touch, pressure, late in the afternoon, after sleeping, in closed and heated rooms.
- Symptoms Better by: in open air, uncovering, and clod bathing.
- Dosage: Apis mel 30, 4 pills 3 times in a day for 1 week